Denician Angeleia

Archive for the ‘Movement Disorders’ Category

Tardive dyskonesia is a chronic movement disorder, a side effect of long-term use of antipsychotic drugs. It is one of the many possible side effects caused by phenothiazines, namely chlorpromazine (Thorazine) and Haldol, which are drugs used in the treatment of schizophrenia and other brain diseases.

In the mid 1900s prior to the use of Thorazine, patients diagnosed with schizophrenia were treated with ECT, or electroconvulsive therapy, and were subjected to lengthy stays in mental institutions. Thorizine was successful in stopping the auditory hallucinations and inhibited the delusions that are common with mental disorders, such as schizophrenia.

Patients who were prescribed phenothiazines for long time periods often developed abnormal muscle twitches. Most of these symptoms are reversible when the patient is given medication as a counteractive measure against the abnormal pseudo Parkinson muscle movements. Milder and reversible side effects of this type of drug include:

1. Akathisia – The need to constantly move around
2. Dystonias – Slow muscular spasms causing uncontrollable movement of the body.

Symptoms of dystonias also include the following:

Stiffness and rigidity of muscle tissue Shuffling when walking Bent over posture Drooling Pill rolling Tremors in the extremities Masked facial expression

The above symptoms are treatable by changing the antipsychotic medication or adding some other drug to reduce tardive dyskonesia symptoms. Although patients had been experiencing these symptoms for some years, it was not until the early 1960s that tardive dyskonesia was initially described. Symptoms include:

- Repeated uncontrolled muscle movement
- Odd facial expressions
- Chewing movements
- Smacking the lips together or pursing them
- Repeated sounds of humming and grunting

Drugs that cause tardive dyskonesia include drugs used in the treatment of gastrointestinal disorders, antidepressants, and antipsychotics.

Who is at risk?

The patients who are at risk for the development of this disease are smokers, females, and diabetics. Again, patients who have been taking these medications for long periods are at risk for developing tardive dyskonesia.

Prevention:

It is possible to prevent TD by restricting the use of the medications, starting with the smallest dose for the shortest amount of time, and using atypical antipsychotics for the treatment of mental disorders.

If you have been taking any of the above medications, you need to talk with your health care provider to address any concerns you may have, particularly if you have been taking these medications for an extended length of time, or if you are beginning to show symptoms of tardive dyskonesia.

Did you realize that women are twice as likely as men to have sleep disorders? Women are known to have frequent sleep problems during their reproductive years.

There are numerous factors which can influence a woman’s ability to have normal sleep patterns. These can include hormone levels, stress levels, lifestyle, sleep environment and menstrual and pregnancy related issues. It’s quite common for women to experience premenstrual sleep disturbances during which they have difficulty falling asleep, may awake during the night, or have difficulty waking up. They may experience daytime sleepiness or suffer from insomnia, which is sleeplessness, and is one of the more common symptoms associated with premenstrual syndrome (PMS).

Many women acquire unhealthy sleep patterns due to the demanding roles they face as mothers, wives and career women. Women tend to choose to ignore fatigue and work long hours, both of which cut into their sleep time. On top if these, women also frequently have their sleep interrupted by their responsibilities as mom.

Women older than 40 years of age report more sleep disturbances than do women in their 20s or 30s. Lack of sleep in perimenopausal women can contribute to decreased job performance, decreased ability to concentrate, a decline in social interaction and a lack of general well-being.

Pregnancy can also be a major factor in sleep disturbance. The sheer demands of pregnancy on the body can make a woman feel sleepy during the day and yet inhibit sleep at night – especially in the first trimester. The pregnant woman may receive better sleep in the second trimester, only to face sleep issues again

Parkinson’s disease is a degenerative disorder of the central nervous system. Parkinson’s disease occurs when nerve cells, or neurons, in an area of the brain known as the substantia nigra die or become impaired. Normally, these neurons produce an important brain chemical known as dopamine. At least 500,000 people in the United States currently have PD. Parkinson’s disease belongs to a group of conditions called movement disorders. Parkinson’s disease is progressive, meaning the signs and symptoms become worse over time. But although Parkinson’s disease may eventually be disabling, the disease often progresses gradually. Parkinson disease affects movement (motor symptoms). Typical other symptoms include disorders of mood, behavior, thinking, and sensation (non-motor symptoms). Individual patients’ symptoms may be quite dissimilar and progression of the disease is also distinctly individual. Parkinson’s usually begins around age 60. It is more common in men than in women. Symptoms of Parkinson’s disease often start on one side of the body first and then affect both sides.

There are many secondary symptoms associated with Parkinson’s disease. Parkinson’s disease patients may notice that they are weaker or more tired. Symptoms include disorders of mood, behavior, thinking, and sensation. Poor balance is due to the impairment or loss of the reflexes that adjust posture in order to maintain balance. Falls are common in people with Parkinson’s. Shaking (muscle tremor). This is one of the first symptoms in three-quarters of people, and affects most people with Parkinson’s disease. Bradykinesia is the phenomenon of a person experiencing slow movements. In addition to slow movements, a person with bradykinesia will probably also have incomplete movement, difficulty initiating movements and sudden stopping of ongoing movement. The progressive loss of voluntary and involuntary muscle control produces a number of secondary symptoms associated with Parkinson’s. Postural instability, or impaired balance and coordination, causes patients to develop a forward or backward lean and to fall easily.

Parkinson’s disease requires broad-based management including patient and family education, support group services, general wellness maintenance, exercise, and nutrition. Medications can help manage problems with walking, movement and tremor by increasing the brain’s supply of dopamine. Amantadine may also be added to carbidopa-levodopa therapy for people in the latter stages of Parkinson’s disease. Catechol-O-methyltransferase (COMT) inhibitors drugs prolong the effect of carbidopa-levodopa therapy by blocking an enzyme that breaks down dopamine. Tolcapone (Tasmar) is a potent COMT inhibitor that easily crosses the blood-brain barrier. A medicine called levodopa is often given to people who have Parkinson’s disease. Called “L-dopa,” this medicine increases the amount of dopamine in the body and has been shown to improve a person’s ability to walk and move around. Thalamotomy involves the destruction of small amounts of tissue in the thalamus — a major brain center for relaying messages and transmitting sensations.

Parkinson’s Disease for Treatment Tips

1. Carbidopa and benserazide are dopa decarboxylase inhibitors.

2. Tolcapone inhibits the COMT enzyme, thereby prolonging the effects of L-dopa, and so has been used to complement L-dopa.

3. Selegiline and rasagiline reduce the symptoms by inhibiting monoamine oxidase-B (MAO-B).

4. An antiviral drug, amantadine, can help reduce symptoms of PD and levodopa-induced dyskinesia.

5. COMT (catechol O-methyl transferase) inhibitors are a new class of drugs that stop the breakdown of dopamine.

6. Other therapies that are important for managing and coping with Parkinson’s disease include physiotherapy, speech therapy, and occupational therapy.

7. Amantadine acts like a dopamine replacement drug but works on different sites in the brain

Sleeping disorder has become the issue of concern in the present age and time. As more and more people are joining the workforce, they are getting all the more stressed out due to hectic work schedules and ever increasing pressure of work. Rapid eye movement sleeping disorder more commonly called REM sleeping disorder has become widespread.

If you feel fatigued the whole day, it is likely that you are suffering from REM sleeping disorder and in such a case, it is better to undergo tests to conform the doubt. Rapid movement of eye takes place during the phase of dreaming. REM happens when you are never able to get adequate sleep as a result of which you feel sleepy and tired during the waking hours. This tends to hamper your performance and level of energy. You don’t feel like indulging in any activity due to lack of energy.

REM sleeping disorder also poses problems in relationships. This is due to the temperamental change that is witnessed in the patients. The person suffering from REM sleeping disorder gets irritated soon and the tolerance power is inhibited. This causes problems in the marital relations especially.

The reason for REM sleeping disorder can be anything but one of the most common causes is a uncomfortable mattress and the second being high level of stress at the workplace and disturbed social life. All these factors combined together lead to sleeplessness. To top it, there is hardly any time for workout and the result is that the body starts aching and also it loses its flexibility. It is here that memory foam mattress comes into play to help you get rid of various forms of pains.

Memory foam mattresses help a great deal in relieving your pain. These mattresses are based on the state of art technology. They make your sleeping experience really pleasurable and people who have used these mattresses have felt a dramatic change in their sleeping pattern. They are of the say that there was a time when they had a lot of difficulty falling asleep and there was immense turning and tossing. Also, they would wake up at night at frequent intervals due to lack of support from the mattress. Memory foam mattresses can be really useful for such people especially in helping them combat their REM sleeping disorder.

Depression is an illness that is very treatable for the most part. Clinical treatments for Depression can include a wide variety of treatments. If you suspect that you might be depressed, you should seek help immediately. Your physician should be a good source of information on mental health services in your area. You can also contact your local mental health organization for assistance. The physician can also help to determine the best course of treatment to meet your needs.

Treatments

Medical procedures including Electroconvulsive Therapy are often used for more serious cases of Depression or cases that are not responding to other treatments. This procedure induces a seizure which is said to release chemicals in the brain and boost the body’s defense system. Long term effects from this procedure include permanent memory loss and possible movement disorders.

Transcranial Magnetic Stimulation is done by passing an electrically charge magnetic coil over the scalp. The currents go through the skull and activate the nerve cells in the brain. This is still considered experimental but is said to have possibilities of becoming a very exact treatment and able to treat other brain disorders.

Anti-depressant medications are often prescribed and usually in conjunction with other treatments such as Psychotherapy. In general they work on the chemicals in the brain called Serotonin and Norepinephrine. Anti-depressants have some very serious side effects. Side effects include a possible reduced sex drive, dry mouth, nausea, at the worst
suicidal thinking and/or attempts.

Herbal supplements contain herbs, vitamins, and other nutritional substances. They are effective and have fewer side effects if any at all. The only drawback is that if you are taking prescriptions for other conditions the herbal supplements could reduce their effectiveness. The best supplements have gone through intensive testing. The ingredients’ interaction should have been studied and the metabolism of the ingredients should have been tested at the molecular level. This guarantees the safety, purity, potency, and effectiveness of the supplement. It further guarantees the consumer they are getting exactly what the label says they are getting.

Psychotherapy is also called talk therapy. It can help with issue such as eating, sleeping, and rejection by helping you to work it out in conversation with a trained therapist. Psychotherapy might be all that’s needed in mild cases but most often it is used along with other treatments such as antidepressants.

Conclusion

Clinical treatments for Depression include medication, psychotherapy and medical procedures such as Electroconvulsive Therapy. Herbal Treatments are also used and may or may not be prescribed by your physician. Before adding anything to your regimen you should consult with your doctor anyway.

One panic disorder treatment most commonly used if the patient wants medical options is antidepressants. Although this treatment is usually related to depression, its scope of treatment includes a number of other psychological conditions, including panic disorder. For a patient to see results of the drugs taking effect, he or she should be committed to taking them for at least two to four weeks. A resolve by the patient to continually use antidepressants for a whole month, even if he or she feels that they are not working, is important. A patient can only start and stop taking antidepressants upon advice of his or her physician.

For treatment of panic disorder, there are two types of antidepressants recommended: the selective serotonin reuptake inhibitors or SSRI and the tricyclic antidepressants. While under this type of medication, it is important for the patient to consult with his or her physician for assessment in intervals of four, six and twelve weeks. Through these consultations, the physician may assess which treatment is proving to be the most effective for the patient while the patient can discuss with the doctor any concerns he or she has with the medication. From the consultations, the physician may also assess if the patient is in need of a different medication type.

The type of antidepressants usually prescribed by a physician first is the SSRI or selective serotonin reuptake inhibitors. This form of antidepressants works by increasing the level of a chemical called serotonin in the brain of the patient. This form of treatment is also the most common doctors prescribe for patients of panic disorder. SSRI treatment usually begins with low doses and is gradually increased by the doctor as the patient’s body adjusts accordingly to the medicine. Patients who take the SSRI treatment may usually experience these side effects:

abdominal pain blurred vision bowel movement associated issues like diarrhea or constipation dizziness dry mouth feelings of agitation headaches insomnia loss of appetite low sex drive nausea sweating

Patients undergoing SSRI for panic disorder treatment may actually be further disconcerted during the initial stages of treatment as feelings of panic and anxiety that the patient is trying to get cured of may seem to get worse. In most cases, this is a temporary phase and the patient will find out that his or her symptoms will start to normalize after a few days of taking this type of medication. However, if the patient starts to feel that the symptoms are getting worse or not returning to normal even after a week or more of taking the SSRI medication, then a consultation with his or her physician is required.

The physician may require the patient to undergo regular blood pressure checks or blood tests when the patient is undergoing this type of panic disorder treatment. If by the 12th week symptoms of the patient have not improved, then an alternative SSRI may be prescribed to see if the latter would have better effects on the patient.